Moles slightly larger than 6 mm
Domenic G.
doctor some moles I have on my back. I have 3 flat moles on my back
-- two are light brown and perfectly circular (the edges are sharp)
and about 7mm in diameter I'd say. The other one is slightly larger
(about 8.5 mm), all one shade of light brown but not perfectly
symmetric. It's oval in shape with a couple of very tiny specs of
white in it, but on one side it looks like somebody bit a small piece
out of it (the skin in that small piece, maybe 2-3mm has no mole color
-- it's like normal skin). On my chest I have another mole, medium
brown, about 7mm in diameter, darker in color than the others but
symmetric.
Anyway, I showed all these to my family doctor and asked him if any of
them should be removed. He said no, because they were all light brown
in color. He just said to keep an eye on them for any changes and to
not expose them to any sunlight. They haven't changed in years as I
look at them every now and then in the mirror. The one that's not
symmetric concerns me though (it hasn't changed in years) -- should I
just go and see a dermatologist on my own and insist that it be
removed? Do dermatologists require referrals from a family doctor?
Aaron Stone MD
benign (aging spots, scars, old or chronic collection of blood under
the skin from venous stasis or after traumatic, seborrheic keratosis,
freckles,
melasma, moles or nevi) or malignant (basal cell carcinoma, melanoma). They
can be congenital (present at birth) or acquired/arise later in life.
Aging spots are due to the gathering of skin pigment cells into patches
or blotches as a result of aging & sun exposure, most commonly on the
back of the hands. Freckles have the same etiology & are found in younger
people or redhaired individuals. They are best treated with 1 or 2 ruby
or yag Q-switched laser treatments. These can be performed with local or
topical anesthetic. If large areas of the face are involved the CO2 or
erbium laser is a better bet as the extra benefit of overall facial
rejuvenation is achieved.
Seborrheic keratosis has a stuck on the skin appearance with an uneven
non-ulcerated surface. It is treated by CO2 laser or surgical excision
or freezing.
Melasma is a light tan to dark brown pigmentation of the face (cheek,
forehead) in a mask like configuration. It is commonly seen in pregnant
women or those taking birth control pills. The pigment lies at a deeper
level than the depth reached by pigment lasers. It is best treated with
creams as pigment lasers can lighten the more superficial skin & make
the lesion look darker.
Moles are effectively lightened with ruby or yag lasers but require
2 to 6 treatments. If they are elevated they will need levelling after
pigment removal by shaving or CO2 laser. Alternatively they can be shaved
level with the skin surface & the base frozen with liquid nitrogen
to prevent regrowth. It is hard to impossible to remove a large elevated
lesion
by liquid nitrogen alone. Also, if the liquid nitrogen is held
to the skin for too long (more than 10 to 15 seconds) all the pigment cells
may be killed resulting in an unsightly white spot.
Characteristics indicative of malignancy are skin ulceration, chronic
drainage, recent noticeable change in an old skin lesion, recurrent skin
infections, variegated or mixed coloration, irregular borders or surface
& large size (more than 5mm). These lesions require biopsy. Also, any
tissue removed should be sent to a pathologist for examination because
physicians are commonly surprised by what looks benign but ends up being
malignant. Current recommendations are that all congenital (present at
birth) moles should be removed & sent for examination by a pathologist
because of the inherent risk of cancerous degenaration in congenital moles.
In short if over the counter creams do not yield a prompt response it
is best to see a qualified physician to be on the safe side. Any suspicous
lesions should be biopsied & sent to a pathologist for examination to avoid
missing a skin cancer.
--
Best wishes
___________________________________________
Aaron Stone MD
Aesthetic & Reconstructive Plastic Surgery
2080 Century Park East, Suite 1110
Century City
Los Angeles, CA 90067
(310)843-9021
FAX(310)277-6510
e-mail - ast...@earthlink.net
http://www.aaronstonemd.com
ICQ #19116074
Accept no substitutes, demand a Plastic Surgeon certified by the
American Board of Plastic Surgery for your cosmetic & reconstructive
Plastic Surgery needs!
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